First reported nosocomial outbreak of Serratia marcescens harboring blaIMP-4 and blaVIM-2 in a neonatal intensive care unit in Cairo, Egypt

Figures & data

Table 1 Antibiotic susceptibility patterns of Serratia marcescens clinical isolates

	KZ	FOX	CAZ	CTX	FEP	MEM	AK	GM	TOB	CIP	LEV	NI	SXT
Sensitive	0%	0%	62.5%	62.5%	62.5%	62.5%	67.5%	92.5%	12.5%	80%	42.5%	0%	95%
Intermediate	0%	0%	0%	0%	0%	0%	2.5%	0%	67.5%	15%	0%	0%	0%
Resistance	100%	100%	37.5%	37.5%	37.5%	37.5%	30%	7.5%	20%	5%	15%	100%	5%

Abbreviations: AK, amikacin; CAZ, ceftazidime; CIP, ciprofloxacin; CTX, ceftriaxone; FEP, cefepime; FOX; cefoxitin; GM, gentamicin; KZ, cefazolin; LEV, levofloxacin; MEM, meropenem; NI, nitrofurantoin; SXT, trimethoprim/sulfamethoxazole; TOB, tobramycin.

Figure 1 Dendrogram of the pulsed field gel electrophoresis patterns showing the genetic relatedness of the 40 Serratia marcescens isolates.

Abbreviation: IC-CDC, Centers for Disease Control and Prevention pulsotype.

Table 2 Antibiotic susceptibilities (minimum inhibitory concentrations, mg/L), molecular characterization of carbapenemases genes, and clonal relatedness of 40 Serratia marcescens clinical isolates

Isolate #	KZ	FOX	CAZ	CTX	FEP	MEM	AK	GM	TOB	CIP	LEV	NI	SXT	Carried genes	Clone
1	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	4	≤0.25	≤0.12	256	≤20	-	A
2	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	256	≤20	-	A
3	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	0.5	≤0.12	256	≤20	-	A
4	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	4	≤0.25	≤0.12	256	≤20	-	A
5	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	256	≤20	blaIMP1	B
6	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
7	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
8	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
9	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
10	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
11	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
12	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
13	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
14	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
15	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	blaIMP1	B
16	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
17	≥64	16	<1	<1	<1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
18	≥64	≥64	≥64	≥64	≥64	≥16	≥64	8	≥16	≥4	≥8	≥512	160	blaIMP1, blaVIM2	A
19	≥64	≥64	≥64	≥64	≥64	≥16	≥64	≥16	≥16	≥4	≥8	256	≥320	blaIMP1, blaVIM2	A
20	≥64	≥64	16	≥64	≥64	≥16	≥64	≤1	4	≤0.25	≤0.12	128	≤20	blaIMP1, blaVIM2	B
21	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
22	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
23	≥64	≥64	≥64	≥64	≥64	≥16	≥64	≤1	≥16	0.5	≥8	256	≤20	blaIMP1, blaVIM2	A
24	≥64	≥64	32	≥64	≥64	≥16	4	2	≥16	0.5	≥8	128	≤20	blaIMP1, blaVIM2	A
25	≥64	≥64	≥64	≥64	≤1	≥16	4	≤1	≥16	0.5	≥8	128	≤20	blaIMP1, blaVIM2	B
26	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
27	≥64	≥64	16	≥64	≥64	≥16	≥64	≤1	2	0.5	1	128	≤20	blaIMP1, blaVIM2	A
28	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
29	≥64	≥64	≥64	≥64	≥64	≥16	≥64	≤1	4	0.5	1	256	≤20	blaIMP1, blaVIM2	A
30	≥64	≥64	16	≥64	≥64	≥16	≥64	≤1	2	≤0.25	0.25	256	≤20	blaIMP1, blaVIM2	B
31	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
32	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
33	≥64	≥64	≥64	≥64	≥64	≥16	≥64	≥16	≥16	2	2	256	≤20	blaIMP1, blaVIM2	A
34	≥64	8	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
35	≥64	≥64	≥64	≥64	≥64	≥16	≥64	4	≥16	2	2	256	≤20	blaIMP1, blaVIM2	B
36	≥64	≥64	16	≥64	≥64	≥16	≥64	≤1	4	≤0.25	≤0.12	128	≤20	blaIMP1, blaVIM2	A
37	≥64	≥64	8	≥64	≥64	8	≥64	≤1	8	≤0.25	≤0.12	128	≤20	blaIMP1, blaVIM2	A
38	≥64	16	≤1	≤1	≤1	≤0.25	≤2	≤1	8	≤0.25	≤0.12	128	≤20	-	A
39	≥64	≥64	≥64	≥64	≥64	≥16	≥64	≤1	≥16	0.5	≥8	256	≤20	blaIMP1, blaVIM2	A
40	≥64	≥64	16	≥64	≥64	≥16	≥64	≤1	2	≤0.25	0.25	256	≤20	blaIMP1, blaVIM2	B

Abbreviations: AK, amikacin; CAZ, ceftazidime; CIP, ciprofloxacin; CTX, ceftriaxone; FEP, cefepime; GM, gentamicin; KZ, cefazolin; FOX; cefoxitin; LEV, levofloxacin; MEM, meropenem; NI, nitrofurantoin; SXT, trimethoprim/sulfamethoxazole; TOB, tobramycin.